Blood transfusions in trauma: six-year analysis of the transfusion practices at a Level I trauma center.
The objective of this study was to analyze the transfusion practices in trauma patients in one institution. A retrospective analysis of the Trauma Registry linked with the Blood Bank Database of a Level 1 trauma center was conducted. Over 6 years, 17 per cent of the 25,599 trauma patients received blood transfusions. The overall mortality in transfused patients was 20 per cent and remained the same during the study period. There was no change in the proportion of patients receiving transfusions throughout the years, however there was a significant 23.5 per cent reduction in the mean number of packed red blood cells (PRBC) units transfused (P < 0.001 for trend). This reduction in PRBC used remained true and even more evident in the group of more severely injured patients (Injury Severity Score > or = 16), with a 27.9 per cent decrease in mean units of PRBC (P < 0.001 for trend). The highest reduction in PRBC transfusion was seen in blunt trauma patients (34.6%, P < 0.001). During the study period there was a concurrent increase in mean units of fresh frozen plasma used (60.7%, P < 0.001) and no change in the use of platelets and cryoprecipitate. In conclusion, transfusions of PRBC were significantly reduced over time in trauma patients without any evident negative impact on mortality.
Teixeira
Pedro G R
PG
Division of Trauma Surgery and Surgical Critical Care, University of Southern California, Los Angeles, California , USA.
Oncel
Didem
D
Demetriades
Demetrios
D
Inaba
Kenji
K
Shulman
Ira
I
Green
Donald
D
Plurad
David
D
Rhee
Peter
P
D000328:Adult; D001803:Blood Transfusion / Q000706:statistics & numerical data*; D002140:California / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D013997:Time Factors; D014193:Trauma Centers / Q000706:statistics & numerical data*; D015599:Trauma Severity Indices; D016896:Treatment Outcome; D014947:Wounds and Injuries / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*